Analysis of the dispositional and functional dimensions of nurses’ social functioning in clinical practice

Introduction

The psychosocial functioning of nurses is a significant part of clinical practice, as it directly affects not only the quality of interpersonal interactions but also the overall efficiency of healthcare provided. It includes both internal individual characteristics and the nurse’s ability to respond adaptively and act effectively in various social situations. In this context, nurses’ social functioning can be analyzed through dispositional and functional dimensions, which allow a more comprehensive understanding of their behavior in the clinical environment (Al Kalaldeh et al., 2020).

Dispositional dimensions

Dispositional dimensions of social functioning represent relatively stable personality predispositions that determine the way nurses respond in interpersonal situations in clinical practice. Key predispositions include empathy, which enables an individual to perceive situations from another person’s perspective and respond to them appropriately. Empathy is a significant factor in the quality of interaction between a healthcare professional and a patient and also affects the psychological well-being of healthcare workers (Van Dijke et al., 2020). A higher level of empathic ability allows nurses to better understand the patient’s situation, identify their emotional needs, and respond appropriately. This creates a foundation for providing high-quality, patient-centered nursing care that reflects individual patient needs and supports the therapeutic relationship. Empathy is also understood as a complex construct including cognitive, affective, and behavioral components (Wang et al., 2020). In nursing science, empathy is also a significant part of nurses’ professional preparation, as it supports the development of patient-centered communication and increases the quality of care provided. Its development is therefore considered one of the preconditions for effective performance in the nursing profession (Xue et al., 2023).

In addition to empathy, social interaction regulation tendencies can also be included among dispositional dimensions, reflecting the ways in which individuals influence the course of communication and dynamics of social situations. As the largest group of healthcare workers, nurses enter into intensive contact with patients and thereby significantly influence the course of treatment. Effective communication and patient education represent basic prerequisites for patient awareness and subsequent adherence to treatment regimens (Wang et al., 2020). Inadequate patient knowledge about illness and treatment can lead to non-compliance with therapeutic recommendations and a higher rate of readmissions. Research highlights the importance of systematic communication during hospitalization and at discharge, and its effective use, including feedback, significantly reduces readmission rates (Oh et al., 2023). Similar conclusions are also presented by other authors (Laari, 2024, Yang et al., 2024), who emphasize that effective communication between nurse and patient is an essential prerequisite for providing individualized care. The development of social competencies allows appropriate interpretation of social situations and flexible responses that benefit both the patient and the healthcare team.

Functional dimensions

Functional dimensions of social functioning reflect the practical ability of an individual to process social stimuli effectively, orient themselves in interpersonal situations, and respond appropriately in them. These dimensions can be operationalized through the TSIS tool, which identifies three core areas: processing social information, social skills, and social perception. Processing social information in nursing practice enables nurses to correctly interpret patient responses, predict their needs, and appropriately adapt their actions to the specific situation. Social skills in nurses appear for example in the ability to conduct a conversation with a patient, handle difficult situations, or coordinate collaboration within a multidisciplinary team. Social perception, or social sensitivity, includes the ability to register and interpret social signals, such as emotions, reactions, or nonverbal expressions of others (Kaliská, Salbot, Heinzová, 2019).

Methodology of the study

The study conducted had a quantitative, descriptive, and cross-sectional character and was aimed at identifying and assessing the level of dispositional and functional dimensions of nurses’ social functioning in clinical practice. Data were collected from January to May 2026, with the questionnaires distributed to respondents in person.

The aim of the study was to analyze the level of dispositional (personality) and functional (behavioral) dimensions of nurses’ social functioning in the clinical environment and point to their importance in the context of interpersonal interactions and the provision of nursing care.

The study sample consisted of 96 nurses working in healthcare facilities in the Slovak Republic. Most respondents were women (80%). In terms of years of professional practice, nurses with up to 10 years of experience predominated (60%), and an equal number of respondents worked in two-shift operations.

Two standardized measurement tools were used for data collection: the Tromsø Social Intelligence Scale (TSIS) (Silvera, Martinussen, and Dahl, 2001) and the MESI questionnaire (Manipulation, Empathy, Social Irritability) (Frankovský, Birknerová 2014).

The Tromsø Social Intelligence Scale (TSIS) is a standardized tool focused on assessing functional dimensions of social functioning. The questionnaire consists of 21 items divided into three subscales: processing social information, social competence, and social perceptiveness. Each subscale contains 7 items. Respondents rate each item on a 7-point Likert scale, where the value 1 indicates very low agreement with the statement and 7 indicates high agreement (Silvera, Martinussen, Dahl, 2001).

The MESI questionnaire represents a psychometric tool enabling assessment of dispositional dimensions of interpersonal functioning. It contains 21 items rated on a 5-point Likert scale (0 = never, 4 = very often). It identifies three core factors: manipulation, empathy, and social irritability (Birknerová & Frankovský, 2011).

The collected data were processed and analyzed using PSPP statistical software (version 25) and Microsoft Excel. For descriptive analysis, basic statistical parameters were used: absolute and relative frequencies (N, %), arithmetic mean (M), standard deviation (SD), minimum, and maximum values.

Results

Functional dimensions of nurses’ social functioning

The average values of the individual TSIS dimensions ranged from M = 4.19 to M = 4.89, which suggests a moderate level of the examined functional characteristics within the 1–7 scale. The lowest average value was reached by processing social information (M = 4.19; SD = 1.72; min = 1.00; max = 7.00), while the highest variability of responses was observed (SD = 1.71), indicating more pronounced individual differences in this area.

The social competence dimension reached an average of M = 4.47 (SD = 1.07; min = 1.71; max = 6.86), and the lower standard deviation suggests a more homogeneous distribution of results and a more balanced profile of the examined abilities across the sample.

The highest mean value was recorded for social perceptiveness (M = 4.89; SD = 1.31; min = 1.29; max = 7.00), which may indicate a relatively higher level of perceiving and interpreting social stimuli compared with the other functional dimensions.

Nurses participating in this study are characterized by a moderate level of functional social functioning, with their strongest area being social perceptiveness, that is, the ability to perceive and interpret social stimuli. Conversely, the lower scores and higher variability in the area of processing social information indicate differences in the ability to interpret social situations. Social competence is at a moderate, relatively balanced level.

Table 1 Functional dimensions of nurses’ social functioning

Dispositional dimensions of nurses’ social functioning

Among the dispositional dimensions measured by MESI, empathy reached the highest mean score (M = 3,69; SD = 0,22; min = 3,14; max = 4,00), while the low variability (SD = 0,22) indicates a more stable and relatively balanced profile of the empathic component in the examined sample of nurses.

The manipulation dimension reached an average of M = 0,80 (SD = 0,15; min = 0,43; max = 1,00), which, given this scaling, suggests that values are concentrated in a narrower interval and variability is rather low to moderate.

The social irritability dimension reached an average of M = 0,81 (SD = 0,20; min = 0,57; max = 1,29), while the standard deviation suggests slightly higher variability than in manipulation.

Nurses participating in our study show a higher and stable level of empathy, while also showing lower variability in manipulation and social irritability tendencies, indicating a relatively balanced and homogeneous profile of dispositional characteristics.

Table 2 Dispositional dimensions of nurses’ social functioning

Nurses in the examined sample are characterized by a moderate level of functional social competencies with a dominance of social perceptiveness, while dispositional profiles show a higher degree of empathy and a relatively stable personality profile, albeit with variability in the area of processing social information.

Discussion

The results of the presented study indicate a moderate level of functional dimensions of nurses’ social behavior in clinical practice, with the highest score recorded in social perceptiveness and the lowest in the dimension of processing social information. This finding is consistent with the results of several studies showing that social functioning dimensions in nurses and nursing students often fall at a rather mild to moderate level, while some components remain less developed. For example, the study by Monis et al. (2024) found that most nursing students achieved lower scores in social intelligence, while still displaying an adequate level of empathy. This finding corresponds to our results, where higher levels of perceptual and empathic abilities also prevail compared with their practical processing.

The dominance of social perceptiveness in the research sample can also be interpreted in the context of broader studies focused on empathy and communication competencies in nursing. Multiple studies indicate a close interconnection between empathy, emotional intelligence, and communication skills, with these factors significantly influencing the quality of clinical care delivered. For example, research by Yang et al. (2024) confirms that empathy and communication skills significantly contribute to nursing competencies and care quality, with strong positive relationships between these variables. Similarly, results of our study suggest that a high level of social perceptiveness likely reflects nurses’ ability to respond appropriately to patient needs, which is a basic prerequisite for therapeutic communication.

In the dispositional dimensions, a high and stable level of empathy was demonstrated, which is consistent with several empirical findings. In nursing, empathy is considered a key competence that significantly influences the nurse-patient relationship and overall quality of care. The study by Giménez-Espert et al. (2020) shows that empathy is one of the main predictors of nurses’ communication attitudes, significantly affecting their interpersonal behavior and ability to establish an effective therapeutic relationship. These findings also support our results, which indicate the dominance of the empathic component among nurses’ dispositional characteristics.

The low values of manipulation and social irritability found in our study can be interpreted as a favorable personality profile that supports prosocial behavior in clinical practice. Although literature using the MESI tool in nursing is more limited, broader research on interpersonal relationships indicates that effective relationships between nurse and patient, as well as within the team, are fundamentally influenced by emotion regulation ability and low levels of conflictual interaction. For example, research by Younas et al. (2023) indicates that underdeveloped interpersonal competencies can lead to conflicts and reduced care quality. Our findings on low social irritability therefore suggest a potentially protective factor in nurses’ interpersonal relationships.

A noteworthy finding is the variability in the dimension of processing social information, which was the highest among the observed functional aspects. This aspect can also be explained in the context of studies showing that cognitive and interpretive components of social intelligence are more influenced by individual differences, experience, and environment than by emotional components. Studies focused on the development of social and communication skills, for example, confirm that these abilities can be significantly modified through education and training, as their level is not stable but dynamic. (Yuksel, Erzincanli, 2023)

From a comparative perspective, it can be stated that our results are generally consistent with international studies that point to:

• a relatively higher level of empathy among nurses,
• a moderate or lower level of social intelligence as a complex construct,
• a significant role of communication and emotional competencies in clinical practice,
• variability in the cognitive components of social functioning.

Based on this, it can be confirmed that nurses’ social functioning is a multidimensional construct in which dispositional characteristics (especially empathy) represent a stable component, while functional dimensions, especially processing social information, are more variable and influenced by experience and education.

Conclusion

Examining dispositional and functional dimensions allows for a more comprehensive understanding of nurses’ social functioning, which cannot be reduced to a unidimensional assessment. The study results pointed to a balanced dispositional-functional profile of nurses, characterized by a higher degree of empathy and social perceptiveness, which represents an important prerequisite for high-quality interpersonal communication in clinical practice.

On the other hand, variability was evident in the area of processing social information, which may indicate individual differences in the ability to interpret and evaluate social situations. Nursing practice is characterized by a high degree of interpersonal interactions, often occurring under emotionally demanding conditions.

From this arises a need for systematic development of not only dispositional but also functional competencies that allow effective handling of social situations, support team collaboration, and contribute to the quality of patient-centered nursing care.

Author: PhDr. Valéria Parová, PhD. University of Pavol Jozef Šafárik, Faculty of Medicine, Institute of Nursing

List of bibliographic references

AL KALALDEH, Mohammad, AMRO, Noor, QTAIT, Mohammad, ALWAWI, Ahmad. 2020. Barriers to effective nurse-patient communication in the emergency department. In: Emergency Nurse. ISSN 1472-0795, 32(5), e1969. DOI: 10.7748/en.2020.e1969

FRANKOVSKÝ, Miroslav, BIRKNEROVÁ, Zuzana. 2014. Detecting social intelligence by MESI methodology psychometric characteristics. In: Individual and Society. ISSN 1335-3608, 17(1), 89–97.

GIMÉNEZ ESPERT, María del Carmen, CASTELLANO RIOJA, Elena, PRADO GASCÓ, Vicente Javier. 2020. Empathy, emotional intelligence, and communication in nursing: The moderating effect of organizational factors. In: Revista Latino-Americana de Enfermagem. ISSN 1518-8345, 28, e3333. DOI: 10.1590/1518-8345.3286.3333

VAN DIJKE, Jeroen, VAN NISTELROOIJ, Inez, BOS, Peter, DUYNDAM, Joachim. 2020. Towards a relational conceptualization of empathy. In: Nursing Philosophy. ISSN 1466-769X, 21(3), e12297. DOI: 10.1111/nup.12297

SILVERA, David H., MARTINUSSEN, Monica, DAHL, Tor Ivar. 2001. The Tromsø Social Intelligence Scale, a self-report measure of social intelligence. In: Scandinavian Journal of Psychology. ISSN 0036-5564, 42(4), 313–319. DOI: 10.1111/1467-9450.00242

WANG, Yu, ZHANG, Ying, LIU, Ming, ZHOU, Lei, ZHANG, Jian, TAO, Hong, LI, Xia. 2020. Research on the formation of humanistic care ability in nursing students: A structural equation approach. In: Nurse Education Today. ISSN 0260-6917, 86, 104315. DOI: 10.1016/j.nedt.2019.104315

XUE, Meng, SUN, Hui, XUE, Jing, ZHOU, Jie, QU, Jing, JI, Shuang, BU, Yan, LIU, Yu. 2023. Narrative medicine as a teaching strategy for nursing students to developing professionalism, empathy and humanistic caring ability: A randomized controlled trial. In: BMC Medical Education. ISSN 1472-6920, 23(1), 38. DOI: 10.1186/s12909-023-04026-5

YANG, Yujie, WANG, Chang. 2024. The chain mediating effect of empathy and communication ability on emotional intelligence and caring ability of nursing students. In: Frontiers in Psychology. ISSN 1664-1078, 14, 1339194. DOI: 10.3389/fpsyg.2023.1339194

YOUNAS, Ahtisham, INAYAT, Shahzad, DAL MOLIN, Alberto, DURANTE, Angela. 2023. Nurses’ challenges to developing interpersonal relationships during integrated care for complex patients. In: Western Journal of Nursing Research. ISSN 0193-9459, 45(10), 894–901. DOI: 10.1177/01939459231189789

YÜKSEL, Ayşe, ERZINCANLI, Serap. 2023. The effect of social skills education on social skills and interpersonal relationship levels in student nurses. In: Journal of Education and Research in Nursing. ISSN 1305-0397, 20(3), 268–276. DOI: 10.14744/jern.2022.22370